Nov 9 More Important Than An Election

The election of 2010 is over. Democrats are still reeling from it, and political strategists are still engaged in "woulda, coulda, shoulda." I'm as disappointed as anyone. But elections are conducted for one purpose and one purpose only: to distribute political power. The measure of a majority is not whether it continues to hold power in the immediate following election, but in how it wields power.

Some things are more important and more lasting than an election. Some things are worth taking a bullet over. Some things are worth fighting for even if the politics of the day tell you not to. Some things are worth losing 60-something seats over. For the sake of country, the fierce urgency of now required the party in power to act with transformational reforms even if it cost them an election.

Health care reform was such a thing, as were the other reforms that are already the legacy of this Congress and President Obama. The Slate's William Saleton makes this point in his article, Pelosi's Triumph

In the national exit poll, voters were split on health care. Unemployment is at nearly 10 percent. Democrats lost a lot of seats that were never really theirs, and those who voted against the bill lost at a higher rate than did those who voted for it. But if health care did cost the party its majority, so what? The bill was more important than the election. [...] The big picture isn't about winning or keeping power. It's about using it.

Exactly. How important? Health care reform will not only provide quality health insurance coverage for 32 million additional Americans, it has already begun to affect the lives of countless people in a positive way. Young adults are now able to stay on their parents' plan until age 26. Children can no longer be denied coverage because of pre-existing conditions (something that will apply to everyone when the exchanges open in 2014). People with pre-existing conditions who were entirely unable to get insurance are now qualifying for coverage through the high risk pools, though they are not cheap by any means.

We know that despite all the right wing screaming against the Affordable Care Act, it has already begun to lower costs for those on Medicare, starting with lowering - yes, actually lowering - Medicare Advantage premiums next year. And now, a new analysis by the Department of Health and Human Services shows that changes in Medicare provided for by the ACA (primarily closing the prescription drug coverage "donut hole") are going to land big savings for beneficiaries. For beneficiaries with high drug costs, ACA is estimated to save $12,300 over ten years, with average saving to all beneficiaries clocked at $3,500.

While Tea Party Republicans and right wing nutjobs have been screaming about "government takeover" of health care, the ACA has been quietly improving the lives of the American people. So it turns out that not giving a 14% extra subsidy to private insurers to provide the same services Medicare already does is actually going to benefit seniors. The biggest savings, as I have mentioned, are going to those with the greatest expenses.

Total savings per traditional Medicare beneficiary are estimated to be $86 in 2011, rising to $649 in 2020 (see Table 1). For a beneficiary with spending in the donut hole, estimated savings increase from $553 in 2011 to $2,217 in 2020.

As policy achievements go, this one was the unlikeliest of the unlikely, and many Democrats paid for it with their jobs. But they proved one thing in this battle: When Democrats have power, they will put the progress of America over holding onto power. Saleton reminds us what President Bush's speechwrite, David Frum said when health reform passed:

Legislative majorities come and go. This healthcare bill is forever. A win in November is very poor compensation for this debacle now. … No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the "doughnut hole" and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents' insurance coverage?

We achieved something that is monumental. We structurally changed, as Saleton says, the "relationship between the public, the economy, and the government." Health care reform eluded Congresses and Presidents for the better part of more than a half century. As President Obama said, it cost the Democrats more politically than he thought. But as Saleton points out in his article:

Politicians have tried and failed for decades to enact universal health care. This time, they succeeded. In 2008, Democrats won the presidency and both houses of Congress, and by the thinnest of margins, they rammed a bill through. They weren't going to get another opportunity for a very long time. It cost them their majority, and it was worth it.

And that's not counting financial regulation, economic stimulus, college lending reform, and all the other bills that became law under Pelosi. So spare me the tears and gloating about her so-called failure. If John Boehner is speaker of the House for the next 20 years, he'll be lucky to match her achievements.

That is it, in a nutshell. Power is never for power's sake. I remember that Howard Dean, the nation's first governor to sign a civil union bill did so 6 months before his re-election, and doing so nearly cost him his election. But to hear him tell it, he never had any regrets about doing what is right because of its political costs. The Democratic Congress and the President did something transformational, something incredible, something that will make America a better country. They did what was right when they had the opportunity. It cost them at the polls. They were rightly willing to pay any cost, bear any burden, take any bullet to do right by the American people. And for that, history will recognize them (and especially Speaker Pelosi and President Obama) as transformational figures in American history to whom generations will owe a debt of gratitude.